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Why is it that, when I was reading a book called Me and My Menopausal Vagina by Jane Lewis, last week, I found it difficult to do so in public – let alone leave it carelessly lying around with the cover facing up?

I have a pretty good idea why.

Perhaps it’s because, in our culture, the menopause is so often seen in a negative light and as something of an affliction. And maybe it’s because it tends to be most often associated with pain, shame, decline, depression, and the end of sexuality and femininity as we know it.

It certainly gets a bad rap, especially in a world that is obsessed with eternal youth and beauty.

Menopause (noun; also known as the climacteric)

Firstly, let’s get the terminology right. The menopause is defined as the permanent cessation of menstruation which marks the end of a woman’s reproductive years. It refers only to a particular day: day 365 of not having a period. The perimenopause, however, is the symptomatic phase, or the period of time it takes for your body to change from a woman who can reproduce to a woman who can’t. This transition period can last for as little as six months and as much as twelve years.

As a biological event for women around the world, the perimenopause and menopause are universal. Every woman will go through it at some time or another. However, research shows that the collection of symptoms during perimenopause are not the same across all cultures. For example, there are a number of anthropological studies* which show that in non-Western cultures (e.g. India, Japan, Hong Kong) women report having only one or two ‘mild’ symptoms such as menstrual changes and muscle stiffness. By comparison, in the UK, the reality is that some perimenopausal women can experience a vast range of symptoms including hot flushes, mood swings, forgetfulness, vaginal atrophy, pain during sex, low self-image, and loss of desire.

Same Same, but Different

Some researchers suggest that lifestyle may play an important role in this geographical variation (in that the hormones are largely influenced by how we eat, sleep and exercise). Others believe that culture is a key factor. In our youth-obsessed Western culture, the menopause is considered to be the end of the road, something to be dreaded. And this can’t be good for our mental health, surely? By contrast, in many cultures, the menopause as a whole represents a time of new freedom, transformation and respect. Older women can enjoy a newfound status in their community and become the source of wisdom on all kinds of themes including menstruation, sexuality, relationships, childbirth, and parenting.

So, if lifestyle and culture have an influence on how women experience this inevitable biological experience is it possible that British women report more symptoms because of the impact of our Western lifestyle choices and stress levels on hormones – and because the perimenopause is treated like a disease rather than a positive and elevating experience such as in other, non-Western cultures?

A Fresh and Welcome View

The lovely thing about Jane Lewis’s book is that, although it is one woman’s very personal account of her experience of the perimenopause, it is told in a bold, frank, explicit and humorous way such that it feels accessible and real. She tells it like it is. And she offers some suggestions for what helped her on her journey by way of natural products, information and support. Most importantly, she is unafraid of talking about it. In fact, she is shouting loudly from the rooftops and encouraging every reader to talk about it too; to their partners and friends, their mothers and their children! After all, almost fifty percent of the world’s population is destined to experience the perimenopause.

So, I urge you to read up around the subject, no matter your age or gender. It is never too early and there is no such thing as too much information. Find out what to expect and how you can help yourself or your partner through the perimenopause. Start the conversation now with your nearest and dearest. Begin by teaching children the correct words for their genitals and by answering their questions about their bodies and about puberty, periods, sex and love. And above all, don’t miss out the menopause! Help beat the shame and secrecy that surrounds it by talking about it, as just another natural and inevitable part of the human condition.

And don’t forget the boys and the men! Because women’s health is a man’s issue too.


*See Flint, 1975; Lock, 1993; and Stefanopoulou et al., 2014

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